What Is a Hemangioma? Is It Cancer, and How Is It Treated?

What Is a Hemangioma?

A hemangiomaconsists of a dense collection of blood vessels.

Hemangiomas most commonly occur on the skin. A cutaneous hemangioma is a birthmark appearing as a bright red nodule made of a tangle of blood vessels.

They most often affect the face, scalp, chest or back. Treatment is generally unnecessary unless vision or breathing is obstructed.

Hemangiomas can affect almost any organ; outside the skin they most often occur in the liver. This article's second part discusses liver hemangioma as its topic.

Childhood Hemangioma

Vascular birthmark is another name for cutaneous hemangioma, which grows during the first year then improves. By age 10, a child who had one in infancy generally has a much less noticeable lesion.

It may be present at birth but appears more often in the first months. It starts as a flat red mark, usually on the face, scalp, chest or back. A child generally has only one.

During the first year, it grows rapidly into a spongy mass protruding from the skin, then enters a resting phase and eventually begins gradually disappearing.

About half improve by age 5 and nearly all resolve by age 10. Although color fades, pale but permanent discoloration or raised skin may remain.

When Should You See a Doctor for Childhood Hemangioma?

The child's doctor monitors it during routine checkups. Contact them if it bleeds, becomes painful or appears infected.

Seek medical care if it affects the child's care, breathing, hearing or feeding.

Causes of Childhood Hemangioma

It is an abnormally dense collection of extra blood vessels. Why they cluster is unclear, although hereditary causes are suspected.

Who Is More Likely to Develop Hemangiomas?

• Females
• Premature infants
• White infants

Diagnosis in Children

Testing is generally unnecessary; diagnosis is based on the characteristic skin appearance described above.

How Is Childhood Hemangioma Treated?

Most need no treatment. Some parents consider treatment necessary because changes in appearance may cause social or psychological problems. Doctors may hesitate to treat lesions without physical problems because most gradually disappear untreated and treatments have potential adverse effects.

If growth interferes with vision or causes other problems, options include:

• Beta-blocker medication. Small superficial lesions may be treated with topical timolol gel, a beta blocker. Propranolol syrup is used for severe infantile hemangiomas. Beta blockers are heart medicines and their adverse effects require care.
• Corticosteroid medication. For children unable to take or unresponsive to beta blockers, corticosteroids (cortisone) may be an option, injected into the nodule, applied to skin or taken orally. Long-term use can impair growth.
• Laser surgery. Lasers sometimes remove hemangiomas or treat painful sores within them.

Research seeks treatments with fewer adverse effects. Experimental options include interferon alfa and topical immunosuppressants.

If considering treatment, discuss benefits and drawbacks with the child's doctor. Remember most childhood hemangiomas disappear spontaneously by age 10.

Liver Hemangioma

A liver hemangioma is a benign (noncancerous) liver mass made of densely clustered blood vessels. It is also called hepatic or cavernous hemangioma.

Most are discovered during imaging for another condition, such as ultrasound. They rarely cause symptoms or complaints and generally need no treatment.

Knowing there is a liver mass can be upsetting even if benign. No evidence shows an untreated liver hemangioma can cause liver cancer.

Rarely, it may cause signs and symptoms (complaints) including:

• Right upper abdominal pain
• Feeling full after eating only a little
• Nausea
• Vomiting
• These are nonspecific and may have another cause even if a liver hemangioma is present.

Make a doctor's appointment for concerning signs or symptoms.

What Causes Liver Hemangioma?

The cause is unclear. They are thought congenital, meaning we are born with them.

A liver hemangioma generally appears as one abnormal vessel cluster larger than approximately 4 centimeters in diameter. Sometimes it is larger. Large lesions can occur in young children, but this is very rare.

In most, it never grows or causes symptoms. In a few, it grows enough to cause complications and require treatment. Predicting whose will grow to cause problems is unclear.

Factors increasing the risk of symptoms include:

• Age. It can be diagnosed at any age but most often between 30 and 50.
• Sex. Women are diagnosed more often than men.
• Pregnancy. Women who have been pregnant are more likely to be diagnosed than those who never have. Rising estrogen during pregnancy may contribute to growth.
• Hormone replacement therapy. For menopausal complaints, women taking hormone replacement therapy may be more likely to receive this diagnosis than nonusers.

Possible Complications

Women diagnosed with liver hemangiomas face complication risk when pregnant. Increased estrogen is believed to enlarge some lesions.

Rarely, a growing lesion causes right upper abdominal pain, bloating or nausea requiring treatment. Having one does not mean you cannot become pregnant, but discussing possible complications helps informed choice.

Diagnosis of Liver Hemangioma

Tests and procedures include:

• Ultrasound (USG)
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)

How Is Liver Hemangioma Treated?

Small, symptom-free lesions need no treatment. Most never grow or cause problems. If large, the doctor may schedule follow-up examinations to check it periodically.

Treatment depends on whether there are multiple lesions, overall health, location, size and your preference for intervention.

Options may include:

• Surgery. If easily removable from the liver, surgery to remove the mass may be recommended.
• Surgery removing part of the liver with the hemangioma. Sometimes surgeons must remove part of the liver alongside the lesion.
• Procedures stopping blood flow to the hemangioma. Without blood supply it may stop growing or shrink. The main artery is blocked (hepatic artery ligation), or medication is injected into it (arterial embolization). Healthy liver tissue is unharmed because nearby vessels supply it.
• Liver transplantation. For a large lesion or multiple lesions untreatable otherwise, the doctor may recommend removing the liver and replacing it with a donor liver.
• Radiation therapy. Radiation uses powerful beams such as X-rays to damage hemangioma cells. It is rarely used because safer, more effective treatments exist.

In summary, hemangiomas are noncancerous growths usually causing no complaints and needing no treatment. If intervention is needed, location, age and personal preferences are considered.